=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508831587
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SPECIALTY PHARMACY SERVICES, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/22/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 800 E MELBOURNE AVE SUITE A
-----------------------------------------------------
City | MELBOURNE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32901-5549
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 321-953-2004
-----------------------------------------------------
Fax | 321-953-2808
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 800 E MELBOURNE AVE SUITE A
-----------------------------------------------------
City | MELBOURNE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32901-5549
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 321-953-2004
-----------------------------------------------------
Fax | 321-953-2808
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VICE PRESIDENT
-----------------------------------------------------
Name | THOMAS D SWITZLER
-----------------------------------------------------
Credential | RPH
-----------------------------------------------------
Telephone | 321-953-2004
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number | PH19222
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------